Prognostic value of neutrophil-to-lymphocyte ratio in pulmonary arterial hypertension

Özpelit, Ebru; Akdeniz, Bahri; Özpelit, Mehmet Emre; Taş, Sedat; Bozkurt, Selen; Tertemiz, Kemal Can; Sevinç, Can; Badak, Özer

doi:10.1177/0300060515589394

Cited by 46 publications

(46 citation statements)

References 39 publications

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“…In patients with severe calcific aortic stenosis, NLR was the independent prognostic factor most significantly associated with major adverse cardiovascular events [17]. In patients with pulmonary arterial hypertension, NLR was also useful for assessment of disease severity [18]. In patients with obstructive sleep apnea syndrome, NLR was independently associated with cardiovascular disease and was a predictor of disease severity [19].…”

Section: Discussionmentioning

confidence: 99%

High Neutrophil-to-Lymphocyte Ratio is a Significant Predictor of Cardiovascular and All-Cause Mortality in Patients Undergoing Peritoneal Dialysis

Wang

Zhang

et al. 2018

Kidney Blood Press Res

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Background/Aims: Chronic inflammation is associated with increased risk of cardiovascular death in patients with end-stage renal disease (ESRD). Although elevated neutrophil-tolymphocyte ratio (NLR), a novel inflammatory marker, has been shown to predict cardiovascular disease and all-cause mortality in the general population, limited evidence is available for its role in ESRD. Methods: We enrolled 86 patients undergoing peritoneal dialysis (PD) for a 36-month follow-up to investigate the association between the NLR and arterial stiffness markers, namely, carotid-femoral pulse wave velocity (cfPWV) and carotid augmentation index (AIx), and mortality in PD patients. The primary endpoints were cardiovascular mortality and all-cause mortality. Kaplan-Meier curves were used to show the cumulative incidence of cardiovascular mortality and all-cause mortality. Results: High NLR was found to be a predictor of increased cfPWV (β = 1.150; P < 0.001) and AIx (β = 3.945; P < 0.001) in patients on PD. Patients with higher NLR had lower survival during follow-up. Kaplan-Meier curves showed that the cumulative incidences of both cardiovascular mortality and all-cause mortality were significantly higher in patients with NLR ≥ 4.5 (both P < 0.01). Conclusion: Our results suggest that high NLR is independently associated with arterial stiffness and predicts cardiovascular and all-cause mortality in PD patients.

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Section: Discussionmentioning

confidence: 99%

High Neutrophil-to-Lymphocyte Ratio is a Significant Predictor of Cardiovascular and All-Cause Mortality in Patients Undergoing Peritoneal Dialysis

Wang

Zhang

et al. 2018

Kidney Blood Press Res

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“…The study demonstrated that an increased neutrophil/lymphocyte ratio was associated with poor functional class and elevated mortality. The prediction of outcome, however, was not independent of other parameters of disease severity [12]. …”

Section: Introductionmentioning

confidence: 99%

Exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertension

et al. 2017

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BackgroundChronic inflammation emerges as a feature of the pathogenesis of pulmonary arterial hypertension (PAH) in experimental models. Alterations of circulating cell subsets have been observed in patients with PAH. We aimed to assess associations of the white blood cell count with disease severity and outcome in patients with PAH.MethodsThe total and differential white blood cell count was related to functional parameters, pulmonary hemodynamics and transplantation-free survival in 77 patients with PAH in an observational single center study.ResultsAn increased neutrophil/lymphocyte ratio was associated with poor World Health Organization functional class and shorter 6-minute walking distance, as well as with elevated right atrial pressure and high level of N-terminal prohormone of brain natriuretic peptide. During a median follow-up period of 31 months (range 16-56) 23 patients died and 2 patients were referred to lung transplantation. Using uni- and subsequent bivariate Cox proportional hazards analyses an increased neutrophil/lymphocyte ratio was associated with unfavorable transplantation-free survival independent of hemodynamic parameters and C-reactive protein. The prognostic implication sustained in subsets of patients with incident PAH and in the absence of cardiovascular risk factors.ConclusionsThe results of this analysis indicate that a neutrophilic inflammation may be associated with clinical deterioration and poor outcome in patients with PAH. Assessing the composition of the differential white blood cell count may render prognostic information and could represent a step towards incorporating an inflammatory marker into the clinical management of patients with PAH.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-017-0407-5) contains supplementary material, which is available to authorized users.

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“…It is an indicator of a necessary harmony between neutrophils and lymphocytes that if disturbed, can be considered as a sign of higher cardiovascular mortality [15]. An example of studies regarding the prognostic role of NLR in cardiovascular conditions other than PTE is the one by Akdeniz and colleagues who investigated the long-term predictability of NLR in Pulmonary Arterial Hypertension and found positive results [16]. In 2017, Vakili et al [17] introduced NLR and PLR as indexes that can be used for risk stratification of no-reflow phenomenon in patients with STEMI undergoing PPCI.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Hematologic Indices with CT-pulmonary Arterial Obstruction Index in Patients with Acute Pulmonary Emboli

Langhroudi

Esfahani

Khaheshi

et al. 2019

ijcp

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Introduction: Acute Pulmonary thromboembolism (PTE) is an imperative medical condition with a considerable global impact. Inflammation is deemed to take a notable part in the pathophysiology of this potentially fatal disorder. The aim of the current study was to predict acute PTE severity in helical pulmonary CT-angiography using easily accessible hematological complete blood count (CBC) indices. Methods: After exclusion of inflammatory conditions that may affect CBC parameters, a total of 69 consecutive patients with definite diagnosis of acute PTE according to pulmonary helical CT-angiography were recruited. Laboratory tests, including CBC parameters were performed on admission in the emergency unit, before initiation of any therapy. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and RDW to platelet ratio (RPR) were calculated in each case of acute PTE. Ultimately, CT pulmonary arterial obstruction index (PAOI) was assessed subsequent to pulmonary helical CT-angiography for each patient. Results: We found that NLR is positively correlated with acute PTE severity according to CT pulmonary arterial obstruction index (PAOI) (P < 0.01, r = 0.56); however, PLR, RDW and RPR did not appear to show such correlations (P > 0.05). Conclusions: NLR could be an easily calculated and capable index to predict severity of acute PTE in pulmonary CT-angiography. Consequently, NLR might be used in precise risk stratification when suspicious for acute PTE and in accurately triage of patients who would benefit greatly from urgent diagnostic and therapeutic interventions.

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Prognostic value of neutrophil-to-lymphocyte ratio in pulmonary arterial hypertension

Abstract: NLR was correlated with important prognostic markers in PAH such as NYHA FC, BNP and TAPSE. This simple marker may be useful in the assessment of disease severity in patients with PAH.

Cited by 46 publications

References 39 publications

High Neutrophil-to-Lymphocyte Ratio is a Significant Predictor of Cardiovascular and All-Cause Mortality in Patients Undergoing Peritoneal Dialysis

High Neutrophil-to-Lymphocyte Ratio is a Significant Predictor of Cardiovascular and All-Cause Mortality in Patients Undergoing Peritoneal Dialysis

Exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertension

Correlation of Hematologic Indices with CT-pulmonary Arterial Obstruction Index in Patients with Acute Pulmonary Emboli

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